Healthcare Provider Details

I. General information

NPI: 1548178874
Provider Name (Legal Business Name): DR. SUJAY SAXENA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BETH ISRAEL DEACONESS MEDICAL CENTER 330 BROOKLINE AVE
BOSTON MA
02215
US

IV. Provider business mailing address

APOLLO HOSPITALS, SCHEME NO. 74C, SECTOR. D, VIGAY NAGAR
INDORE M.P.
452010
IN

V. Phone/Fax

Practice location:
  • Phone: 617-667-3524
  • Fax: 617-667-3513
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: